Chapter 5: Beyond Behaviors

Dr. Delahooke begins the chapter with a case study about a little boy who had many behavioral challenges.  The four-step process she used to determine strategies to assist the child is IDEA.  This stands for Inquire, Determine, Examine, Address.

Inquire:  Find out the child’s history and look for behavior patterns.

Determine:  Try to figure out what is distressing the child.

Examine:  Look at for causes and triggers.

Address: Support with interactions developmental problems that are causing behaviors.

It is imperative to get a history of the child to gather information about prenatal experiences, the first few month of life, and early childhood.  Some forms you may want to use for this purpose are linked below.  (Dr. Delahooke has her own worksheets included in her book for use.) Developmental History Questionnaire

This is done in addition to keeping a behavior journal and tracking behavior for several weeks.  This should help identify triggers or patterns.  If patterns are not found, ask a wider variety of health questions such as sleep patterns, nutrition/food intake, regularity/toileting.  

In the case study, after history and behavior tracking were gathered no pattern emerged.  However, when general health questions were asked it was discovered that the child had poor sleep.  The first goal was to attempt to get the child to sleep regularly every night.  Then to determine what, if any, benefit that would have on behavior.

However, the daily tracking had to continue to find other patterns. Click here for more about Behavior tracking.

In doing so, the child’s parents recognized that constipation would increase tantrums as it was one of the child's stressors.

The child's plan to help sleep cycles began several hours before actual bedtime.  The plan included soft lighting and soothing music.  Screen time ended earlier and books were read.  Parents monitored their attitudes and voice levels to reduce stress on the child. After solving these physical issues, they then began address the missing foundations for regulation and attention.

Once sensory preferences are identified, they can be used to help a child calm him/herself.  (Food is not a recommended tool, as it is a risk factor for obesity.) Be careful in experimenting with these, as some sensory experiences have an emotional reaction attached, and could set off triggers.  Use of sensory preferences are to be used with an adult helping the child first.  This emotional co-regulation is the prerequisite to emotional self-regulation. 
Click the link to see a Sensory Checklist that might be helpful for you.

In working with a child who is in the middle of a tantrum, be gentle, slow, and provide cues of safety. When the child is more relaxed ask what helps him/her calm down. See Sesame Street's Dealing with Tantrums resources.

Children who are shutdown and withdrawn need to be given cues of connection and love gently.

Some children have an especially difficult time calming their bodies.  Activities such as sports, yoga, meditation etc. can help if the child finds these activities enjoyable. Once children develop the awareness of what their bodies are telling them they can learn self-care techniques.

Mindfulness Exercise for Children
These practices help the child settle and develop an awareness of their bodies. This leads to teaching a child how to care for themselves based on what their body is telling them.

Sending Friendly Wishes
This is a strategy that helps children send good thoughts to others and themselves.  This approach uses body up techniques, such as relaxing and breathing, paired with a top down method like guided imagery.
See more at https://www.susankaisergreenland.com/watch-1/friendly-wishes

Dr. Delahooke's concluding point is that you can use body up approaches to scaffold top down strategies.